Worms belong to the most ancient creatures on earth, parasitic in the human body. Glistovye infestations according to WHO, are the cause of death of about a third of all deaths on the planet, recorded annually. Of the 250 types of parasites that are hazardous to health, in a certain area, there are no more than a few dozens, and the rest are extremely rare.
Infection occurs in different ways. But the most dangerous are invasions caused by rare tropical worms, which provoke the development of dangerous diseases. This is due to the complexity of the diagnosis, the long life cycle of these worms and the destructive effect of their mechanical influence and the products of the disintegration of parasites on the human body. Areas of their habitat are countries with a hot climate and the presence of a high level of humidity, which is why their name is called "tropical".This preference is due to the fact that the carriers are blood-sucking insects that live in a marshy warm terrain or through contaminated soil when walking barefoot.
A parasite called rishta, which is also called a medical string, is transmitted through the water crickets-cyclops, which are swallowed by a man from natural reservoirs. The larvae of the parasite cause subcutaneous abscesses and when dirt gets into them, or when a mature adult female spits a larva into this area. With this, the pain becomes unbearable and the phlegmon is formed on the site of the abscess. The list of tropical helminthiases includes:
- lymphatic filariasis;
- food grade trematodosis( clonorhoz, opisthorchiasis, fascioliasis, paragonimosis).
Rare human helminthiasis are called infestations, which occur no more than one case per one hundred thousand of the population, and the diagnosis of which is very complicated. However, it is these parasites that provoke very serious complications from the internal organs, too complicated for treatment. To carry out the determination of the species of rare helminths, various studies of duodenal contents, urine, blood, feces, surface skin bioptates for the presence of eggs or larvae of parasitic worms are carried out. In addition, they study the features of the clinical picture and the epidemiological analysis.
The manifestation polymorphism is most typical for clonorchosis, which is common in South-East Asia, and on the territory of Russia - in the Amur River basin or the Far East. The source of infection is a person who with feces secretes eggs of worms( Chinese fluke) and intermediate hosts( mollusks, carp fishes) with insufficient treatment infects a healthy person. The life cycle of the parasite in the body reaches forty years. With a small number of parasites, there is no symptomatology, but with a massive infection, the biliary tract becomes blocked and chronic inflammation develops. Further parasites can lead to the development of cancer of the biliary tract. Statistics of lesions of rare helminthiases are absent, but even on the basis of known facts of these diseases, it can be said that the tendency of defeat by rare parasites persists.
The disease of dracunculiasis is caused by a round worm - rishta, in translation from the Tajik meaning "thread".The similarity of the parasite with the shape of the dragon served as the basis for the name of the disease, which originated from the Latin expression "hit with small dragons".The nematode is quite large and the female can reach a length of more than a meter( 120 centimeters), but the male is much smaller in size( 12-30 mm).The male has an end turned to the peritoneum.
Dracunculiasis( rishta) infection occurs when ingestion of water containing cyclopean crayfish invaded by mature parasite larvae. When cyclops enter the gastrointestinal tract, the microfilaria through the intestinal walls migrate to the lower extremities. Three months after the infection with dracunculiasis, the female is fertilized and, in the subcutaneous tissue, begins production of larvae. Increasing in size, by its end the female reaches the surface of the skin, causing the formation of bubbles filled with liquid and reaching up to eight centimeters in diameter. Breaking the uterus and the walls of the parasite, larvae, the number of which reaches three million, come out from the front end of the female, penetrate through the skin to the outside. The liberation of the female from the larvae lasts for 2-3 weeks, and then it perishes. In the body of people the worm lives no more than a year and a half.
The most common dracunculiasis in countries with hot and arid climate, where people drink water from infertile artificial or natural water bodies and walk barefoot. Conditions for the spread of dracunculiasis are unsanitary conditions, absence or poor water supply. Therefore, most often poor people who live in uncomfortable dwellings, who use feces for fertilizing the land, are infected. Contaminated waters of infected people occur when they enter the water during ritual ablutions or to take water with bare feet.
Symptoms and treatment of dracunculiasis
The main indication of the presence of invasion is the cord-like formation under the skin. Among the clinical manifestations are:
- allergic reactions in the form of urticaria, asphyxiation;
- swollen joints;
- burning pain;
- ulcers, blisters, erythema in the outlets of the parasites out.
Confirmation of the accuracy of the diagnosis is served by serological studies, and the establishment on the bottom of the ulcer of the head of the worm.
The unbearable pain of dracunculiasis is weakened when immersed in cold water, but intensive infestation of the larvae of water and the further spread of invasion occur. Depending on the location of the parasite, the course of helminthic invasion is complicated by the development of joint diseases( arthritis, synovitis, contractures, hookworm).If this causes a bacterial infection, then necrosis of the tissues, up to gangrene and sepsis, is possible. In practice, cases of tetanus, pericarditis, pleurisy, orchitis, epididymitis are described, which are caused by the consequences of ristoi invasion.
If the parasite emerges from under the skin, as can be seen in the photo of dracunculiasis, then it can be removed by wrapping it on a stick or gauze roll. Carry out this action very carefully to avoid breaking the body of the parasite. As a rule, no more than 10 cm of a threadlike body can be extracted in one step. Continue the operation to remove the helminth probably the next day. The remains of the body of the parasite are surgically removed.
Treatment of dracunculiasis is carried out in complex with the use of antinematous agents, preparations for the removal of pruritus, antiseptics and other necessary medications. Considering that mostly helminths appear on the lower extremities, tetanus prophylaxis is recommended. In some cases, specific chemotherapy is carried out. To facilitate the exit and pull the parasite from the body apply Piridazolum, Thiabendazole, Metronidazole. With the timely taking of measures, the forecast is usually favorable. Effective prevention of the disease is the treatment of water sources with special preparations, providing the population with clean drinking water and observing sanitary rules.